EP2291112B1 - Optisches nachweisverfahren und gerät zum optischen nachweis des zustands von gelenken - Google Patents

Optisches nachweisverfahren und gerät zum optischen nachweis des zustands von gelenken Download PDF

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Publication number
EP2291112B1
EP2291112B1 EP09757912.2A EP09757912A EP2291112B1 EP 2291112 B1 EP2291112 B1 EP 2291112B1 EP 09757912 A EP09757912 A EP 09757912A EP 2291112 B1 EP2291112 B1 EP 2291112B1
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Prior art keywords
body part
blood flow
joint
optical detection
blocking
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English (en)
French (fr)
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EP2291112A2 (de
Inventor
Wouter H. J. Rensen
Michael C. Van Beek
Rik Harbers
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Demcon Hemics BV
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Hemics BV
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813—Specially adapted to be attached to a specific body part
    • A61B5/6825—Hand
    • A61B5/6826—Finger
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/683—Means for maintaining contact with the body
    • A61B5/6838—Clamps or clips

Definitions

  • the present invention relates to an optical detection method and to a device for optical detection of the condition of joints.
  • the term light is to be understood to mean non-ionizing electromagnetic radiation, in particular with wavelengths in the range between 400 nm and 1400 nm.
  • body part means a part of a human or animal body.
  • blocking covers both complete blocking and blocking to a substantial extent.
  • the present invention relates to optical detection of joint conditions, in particular to the optical detection of joint diseases such as rheumatoid arthritis (RA).
  • RA rheumatoid arthritis
  • the treatment of such joint diseases is staged. Usually, a patient first receives pain killers. These are frequently followed by non-steroid anti-inflammatory drugs (NSAIDs) and disease modifying anti-rheumatic drugs (DMARDs).
  • NSAIDs non-steroid anti-inflammatory drugs
  • DMARDs disease modifying anti-rheumatic drugs
  • the last stage in treatment with drugs is the use of biological therapies. In particular the last category is expensive and treatment can cost tens of thousands of dollars per year per patient. Additionally, the drugs used in later stages of treatment often cause more severe side effects.
  • medical professionals base their decisions on changes in therapy on disease activity which is given by the number and the severity of inflamed joints.
  • DOT Diffuse Optical Tomography
  • inflammation can be recognized by a change in perfusion.
  • Blood constituents in particular both oxygenated and deoxygenated hemoglobin have distinct optical characteristics compared to other constituents of the human or animal body and thus can in principle be optically detected.
  • US 6 424 859 B2 discloses a near infrared spectroscopic technique for characterizing the condition of a joint. The results from a spectroscopic measurement are compared to a database in which measurement results for a plurality of arthritic and healthy joints are stored. However, this technique does not allow satisfactorily separating signals resulting from blood and signals from other sources in the body. Further, the technique does not allow separating joint-specific features from features resulting from tissue such as skin, fat, etc.
  • US 6 587 704 B1 discloses a method for non-invasive measurement of blood parameters in which a condition of artificial kinetics by stopping blood flow during measurement.
  • the optical detection method and the device for optical detection of the condition of joints shall provide sufficient information to assist a medical professional to come to a conclusion with respect to the joint condition and disease activity, respectively.
  • an optical detection method a body part comprising at least one joint is irradiated with light and local attenuation of the light by the body part is detected as attenuation measurements at the position of the at least one joint and at the position of at least one other portion of the body part. Blood flow to and/or from the body part is temporarily at least partially blocked and thereafter enabled again. Distinct local attenuation measurements for the at least one joint and for the at least one other portion of the body part are performed for at least two of the times before, during, and after the blocking of blood flow.
  • Measurements before and after the blocking of the blood flow can give relevant data, if only because it can take the body a remarkable long time (>5 minutes) to fully recover and return to the same transmission properties as before the measurement. Since the attenuation of the light used for irradiation is locally detected for two distinct positions of which at least one is a joint, differences in the optical properties of the at least one joint compared to the at least one other portion of the body part can be detected. Since the distinct local attenuation measurements are performed before and during the blocking of blood flow, before and after the blocking of blood flow, and/or during and after the blocking of blood flow, the response of the at least one joint to changes in blood flow compared to the at least one other portion can be detected.
  • the number and properties of blood vessels (capillaries) in the joint change. This effect together with the specific light absorption of blood is used for measuring the condition of a joint. Due to the measurements under different blood flow conditions, the signal resulting from blood can be separated from signals resulting from other sources of light attenuation in the body. Since at least one joint and at least one other body portion of the body part (e.g. next to the joint) are measured, joint-specific results are achieved and contributions from tissues which are present in both the joint and the other body portion (such as fat, skin, etc.) can be separated. As a result, a signal which is joint-specific for changes in blood content can be obtained. Separate measurements to identify the composition (e.g.
  • the distinct local attenuation measurements for the at least one joint and for the at least one other portion of the body part are performed at all three intervals before, during, and after the blocking of blood flow. In this case, even more information about the condition the at least one joint is provided.
  • the response of different joints to changes in blood flow can be compared and information about differences in the condition of several joints is provided.
  • continuous distinct local attenuation measurements are performed before the blocking of blood flow, during the blocking of blood flow, and after the blocking of blood flow.
  • exact information about the time point of a response to a change in blood flow is provided for the at least one joint and the at least one other portion.
  • the differences in response between the at least one joint and the at least one other portion are provided in an advantageous way.
  • the blood flow is blocked by application of pressure.
  • a simple and convenient way for obstructing the blood flow is provided.
  • the body part is immersed in an optically matching medium.
  • optical boundary effects and the dynamic range of intensities to which a detector is subjected are reduced.
  • the object is further solved by a device for optical detection of the condition of joints according to claim 7.
  • the device comprises: a measurement unit for irradiating a body part comprising at least one joint with light and locally detecting attenuation of the light at the at least one joint and at least one other portion of the body part; a blood flow blocking unit for blocking the blood flow to and/or from the body part; and a control unit.
  • the control unit controls the device such that: blood flow to and/or from the body part is temporarily at least partially blocked and thereafter enabled again; and distinct local attenuation measurements for the at least one joint and for at least one other portion of the body part are performed for at least two of the times before, during, and after the blocking of blood flow.
  • the blood flow blocking unit is adapted to block the blood flow by application of pressure, the advantages can be realized in a simple and convenient way.
  • the measurement unit comprises a light source unit capable of emitting light of at least two distinct wavelengths
  • one wavelength can be chosen such that blood has a high absorption and another wavelength can be chosen such that the absorption of blood is low or comparable to surrounding tissue.
  • the light source unit comprises at least two lasers.
  • well defined wavelengths are provided and differences in perfusion can be detected with high accuracy.
  • the device is a medical optical detection device.
  • Fig. 1 schematically shows a set-up for the optical detection of the condition of joints.
  • a human body 4 is schematically shown as a body and a hand forms the body part 5 to be examined.
  • the invention is not restricted to human bodies and e.g. animal bodies may be subjected to examination.
  • the body part 5 is not restricted to a hand but may also be formed by another body part comprising at least one joint 6 such as arms, legs, feet, etc.
  • the device for optical detection of the condition of joints comprises a measurement unit 2, a blood flow blocking unit 3, and a control unit 1.
  • the control unit 1 is provided to control the operation of the device and data acquisition.
  • the measurement unit 2 is provided to irradiate portions of the body part 5 under examination with light and measure the local attenuation of the light at different positions of the body part 5.
  • the measurement unit 2 is formed by a measurement head which will be described in more detail below.
  • the blood flow blocking unit 3 is provided for temporarily blocking the blood flow to and/or from the body part 5 under examination.
  • the blood flow blocking unit 3 is provided by a pressure cuff surrounding the arm to which the hand under examination belongs and obstructing the blood flow by application of pressure to the upper arm. It should be noted that the blood flow blocking unit 3 may be adapted differently in order to allow temporarily at least partially blocking the blood flow to and/or from body parts 5 other than a hand.
  • the measurement unit 2 schematically shown in Fig. 2 is adapted for attenuation measurements in transmission geometry.
  • the measurement unit 2 comprises a light source unit 21 emitting a beam of light for irradiating the body part 5.
  • the light source unit 21 comprises at least one light source and appropriate light guides to direct the beam of light to the body part 5.
  • the light source may be formed by a lamp or by one or more lasers and the light guides may for instance be formed by optical fibers.
  • the light source unit 21 is adapted to be capable to emit light of at least two different wavelengths, preferably in the red to near infrared, wherein one wavelength is chosen such that blood has a high absorption and another wavelength is chosen such that the absorption of blood is low or comparable to surrounding tissue.
  • Suitable wavelengths are for instance 600 nm and 805 nm but other wavelengths fulfilling these criteria are possible as well. Wavelengths in the wavelength range between 550 and 980 nm are particularly suitable.
  • an optical component 22 which e.g. may be formed by a lens is provided for directing the light to the body part 5.
  • the optical component 22 is capable of concentrating the light (irradiation light 25) on a specific area of interest (or several specific areas of interest; i.e. specific positions) of the body part 5 as will be described below.
  • a second optical element 23 is provided to collect light emerging from the specific area (or areas) of interest and direct the collected light 26 to a detection element 24.
  • the detection element 24 may for instance be formed by a photodiode, a CCD, an optical guide such as a fiber connecting to a photodiode, or another light detection scheme known in the art.
  • the measurement unit 2 is adapted such that distinct local attenuation measurements for at least two different portions of the body part 5 can be performed.
  • the control unit 1 is adapted such that it controls at least partial blocking of the blood flow to and/or from the body part 5 by means of the blood flow blocking unit 3. Further, it controls the measurement unit 2 such that local attenuation measurements are performed before the blood flow is blocked (interval I in Fig. 4 ), local attenuation measurements (at the same positions) are performed during the blocking of blood flow (interval II in Fig. 4 ), and local attenuation measurements (at the same positions) are performed after restoring the blood flow (interval III in Fig. 4 ).
  • Fig. 4 shows an example of attenuation measurements (optical intensity measurements) over time on a finger joint as a particular area of interest before the blocking of blood flow (I), during the blocking of blood flow (II; "occlusion"), and after the blocking of blood flow (III). It can be seen that the attenuation measurements in the three time intervals (before (I), during (II), and after (III) occlusion) are performed continuously to achieve time-resolved measurements. It can be seen that the measured intensity drops after blocking the blood flow and rises again after restoring of the blood flow. However, the height of the drop and the time relation between the blocking/restoring of blood flow and change in the measured intensity provide important information about the condition of the joint 6 under examination.
  • Attenuation measurements are not only performed for a single joint 6 but at least one joint and at least one other portion of the body part under examination are measured simultaneously, i.e. within the same cycle of normal blood flow (I), obstruction of blood flow (II), and restoration of the blood flow (III). This is achieved by simultaneously performing distinct local attenuation measurements at the position of the at least one joint 6 and at the position of the at least one other portion of the body part 5.
  • the at least one other portion of the body part may be another joint or a portion which is not a joint and serves as a reference portion.
  • Attenuation measurements are performed for the at least two different wavelengths of the irradiation light for one of which blood has a high absorption and for the other one of which absorption of blood is low or comparable to surrounding tissue.
  • attenuation measurements for multiple joints of a patient are performed simultaneously. In the preferred embodiment, all joints in both hands are measured simultaneously.
  • the following steps are performed according to the embodiment: distinct local attenuation measurements for at least one joint and at least one other portion of the body part 5 are performed; the blood flow to the body part 5 under examination is temporarily blocked by means of the blood flow blocking unit 3 and distinct local attenuation measurements for the at least one joint and the at least one other portion are performed; and the blood flow is restored and distinct local attenuation measurements for the at least one joint and the at least one other portion of the body part 5 are performed.
  • several attenuation measurements are performed to achieve a time-resolved measurement.
  • the time dependent behavior of the at least one joint and the at least one other portion of the body part 5 are analyzed both independently and with respect to each other. Exploiting the measurements for at least two different wavelengths allows analyzing the perfusion dynamics and oxygenation.
  • Fig. 3 shows a hand as an example for a body part 5 to be examined and the positions of joints 6 are indicated by crosshairs (it should be noted that not all joints are provided with reference signs).
  • the indicated positions can be used as positions for the local attenuation measurements and additionally positions between these indicated positions can be used for reference attenuation measurements.
  • the control unit 1 detects the spectral characteristics of the body part 5 containing joints 6. After a baseline measurement, the blood flow is (at least partially) blocked by the blood flow blocking unit 3. The measurement unit 2 now detects spectral changes related to the reduced blood flow. After some time, e.g. 30 seconds, the blood flow is restored by operating the blood flow blocking unit 3 appropriately (e.g. releasing the pressure cuff). The measurement unit 2 detects how fast the perfusion is restored in the joints and in which order the perfusion is restored. Preferably, the perfusion recovery is also compared between joints and other areas of the body part 5. Inflamed joints will have a different perfusion and oxygenation as compared to healthy joints. As a result, the dynamic spectral behavior which is measured by the measurement unit 2 will be different.
  • Fig. 5 shows an example for the results of attenuation measurements (in transmission geometry) performed simultaneously.
  • the trace marked with T1 corresponds to local attenuation measurements at a first joint
  • the trace marked with T2 corresponds to local attenuation measurements at a second joint
  • the trace marked with R1 corresponds to local attenuation measurements at a reference position which is not a joint.
  • the characteristics A, B, C of the drops occurring in the traces can be different.
  • a single drop can be analyzed and also the relation between the drops A, B, C in the different traces T1, T2, and R1.
  • Inflamed joints can show signs of high perfusion such as an increased drop in transmission compared to other joints or compared to a reference position.
  • the time differences D, E between the changes in transmission between the traces T1, T2, and R1 can be used as marker for inflammation and provide important information.
  • the measurement unit 2 has been adapted for measurements in transmission geometry, i.e. the body part is irradiated from one side and the light having passed through the body part is measured on the opposite side.
  • the measurement unit 2 can be adapted for attenuation measurements in reflection geometry. In this case, irradiation and detection are performed from the same side of the body part 5.
  • the optical components 22 and 23 can be combined. It is advantageous to separate the diffuse reflected light from the illumination light. This can be achieved e.g. by orthogonal polarized spectral imaging (OPSI) or darkfield imaging or other suitable techniques known in the art.
  • OPSI orthogonal polarized spectral imaging
  • darkfield imaging or other suitable techniques known in the art.
  • the blood flow need not be completely blocked but a substantial reduction of the blood flow may suffice.
  • a plurality of different ways for implementing the measurement unit 2 exists. It is an essential feature that the local collection of light from multiple portions of the body part 5 under examination is measured. This can e.g. be achieved by illuminating a single spot at a time and detecting a corresponding single spot on the body part 5 and scanning the position of the illumination and detection spot over the body part 5.
  • a further, more preferred possibility is to illuminate the whole body part 5 and to image the transmitted (or reflected) light with a CCD camera or another suitable camera.
  • a CCD camera or another suitable camera due to the diffuse transmission, in this case the resolution of the image is limited and light traveling e.g. between fingers may overload the detector.
  • a still more preferred possibility is to illuminate a discrete number of spots on the body part 5.
  • This implementation has the advantage that less stray light reaches the detector which leads to a higher resolution and that the intensity of all the spots can be adjusted such that only a limited dynamic range is required for the detector.
  • an optically matching medium e.g. a fluid
  • a fluid having optical properties such as the optical absorption coefficient and the reduced scattering coefficient
  • the illumination wavelength it is possible to alternate the illumination wavelength. It is also possible to illuminate with all required wavelengths simultaneously and separate the different wavelengths in the detection path, e.g. using filters or a spectrograph.
  • multiple body parts e.g. both hands are measured simultaneously.
  • the invention is not restricted to that.
  • a larger number of discrete wavelengths can be used or even a complete spectrum over a certain range of wavelengths (e.g. 650 to 1000 nm).
  • acquiring a complete spectrum requires more costly components as compared to a few distinct wavelengths.
  • tissue components such as fat, water, etc.

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Claims (10)

  1. Verfahren zur optischen Detektion des Zustands von Gelenken, wobei
    ein Körperteil (5), das wenigstens ein Gelenk (6) enthält, mit Licht bestrahlt wird und
    lokale Abschwächung des Lichts durch das Körperteil (5) im Wesentlichen gleichzeitig als Abschwächungsmessung an der Position des wenigstens einen Gelenks (6) und an der Position von wenigstens einem anderen Bereich des Körperteils (5) detektiert wird, und wobei
    der Blutfluss zu und/oder von dem Körperteil (5) zeitweilig wenigstens teilweise blockiert und danach wieder freigegeben wird,
    verschiedene lokale Abschwächungsmessungen für das wenigstens eine Gelenk (6) und für wenigstens einen anderen Bereich des Körperteils (5) im Wesentlichen gleichzeitig zu wenigstens zwei Zeitpunkten von vor (I), während (II) und nach (III) der Blockierung des Blutflusses durchgeführt werden und
    wobei die Resultate der verschiedenen lokalen Abschwächungsmessungen für das wenigstens eine Gelenk (6) und für den wenigstens einen anderen Bereich des Körperteils (5) miteinander verglichen werden.
  2. Verfahren zur optischen Detektion nach Anspruch 1, wobei die verschiedenen lokalen Abschwächungsmessungen für das wenigstens eine Gelenk (6) und für den wenigstens einen anderen Bereich des Körperteils durchgeführt werden vor (I), während (II) und nach (III) der Blockierung des Blutflusses.
  3. Verfahren zur optischen Detektion gemäß einem der Ansprüche 1 und 2, wobei der wenigstens eine andere Bereich des Körperteils (5) ein anderes Gelenk ist.
  4. Verfahren zur optischen Detektion nach einem der Ansprüche 1 bis 3, wobei, für das wenigstens eine Gelenk (6) und den wenigstens einen anderen Bereich des Körperteils (5), verschiedene lokale Abschwächungsmessungen kontinuierlich durchgeführt werden vor der Blockierung des Blutflusses (I), während der Blockierung des Blutflusses (II) und nach der Blockierung des Blutflusses (III).
  5. Verfahren zur optischen Detektion nach einem der Ansprüche 1 bis 4, wobei der Blutfluss durch Anwenden von Druck blockiert wird.
  6. Verfahren zur optischen Detektion nach einem der Ansprüche 1 bis 5, wobei, während der Aufnahme der verschiedenen lokalen Abschwächungsmessungen, das Körperteil (5) in ein optisches Anpassungsmedium eingetaucht ist.
  7. Gerät für die optische Detektion des Zustands von Gelenken, wobei das Gerät aufweist:
    eine Messeinheit (2) zum Bestrahlen eines Körperteils (5), das wenigstens ein Gelenk (6) enthält, mit Licht und zum im Wesentlichen gleichzeitigen Detektieren der Lichtabschwächung an dem wenigstens einen Gelenk (6) und an wenigstens einem anderen Bereich des Körperteils (5),
    eine Blutfluss-Blockiereinheit (3) zum Blockieren des Blutflusses zu und/oder von dem Körperteil (5)
    und eine Steuereinheit (1), die das Gerät so steuert, dass:
    der Blutfluss zu und/oder von dem Körperteil (5) zeitweilig wenigstens teilweise blockiert und danach wieder freigegeben wird und
    verschiedene lokale Abschwächungsmessungen für das wenigstens eine Gelenk (6) und für den wenigstens einen anderen Bereich des Körperteils (5) im Wesentlichen simultan durchgeführt werden zu wenigstens zwei Zeitpunkten von vor (I), während (II) und nach (III) der Blockierung des Blutflusses und die Resultate der verschiedenen lokalen Abschwächungsmessungen für das wenigstens eine Gelenk (6) und für den wenigstens einen anderen Bereich des Körperteils (5) miteinander verglichen werden.
  8. Gerät zur optischen Detektion des Zustands von Gelenken nach Anspruch 7, wobei die Blutfluss-Blockierungseinheit (3) dazu ausgestaltet ist, den Blutfluss durch Anwendung von Druck zu blockieren.
  9. Gerät zur optischen Detektion des Zustands von Gelenken nach einem der Ansprüche 7 und 8, wobei die Messeinheit (2) eine Lichtquelleneinheit (21) aufweist, die zur Ausstrahlung von Licht mit wenigstens zwei verschiedenen Wellenlängen in der Lage ist.
  10. Gerät zur optischen Detektion des Zustands von Gelenken nach Anspruch 9, wobei die Lichtquelleneinheit (21) wenigstens zwei Laser aufweist.
EP09757912.2A 2008-05-26 2009-05-20 Optisches nachweisverfahren und gerät zum optischen nachweis des zustands von gelenken Active EP2291112B1 (de)

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EP09757912.2A EP2291112B1 (de) 2008-05-26 2009-05-20 Optisches nachweisverfahren und gerät zum optischen nachweis des zustands von gelenken

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EP08156917 2008-05-26
PCT/IB2009/052112 WO2009147560A2 (en) 2008-05-26 2009-05-20 Optical detection method and device for optical detection of the condition of joints
EP09757912.2A EP2291112B1 (de) 2008-05-26 2009-05-20 Optisches nachweisverfahren und gerät zum optischen nachweis des zustands von gelenken

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EP2291112B1 true EP2291112B1 (de) 2017-11-08

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US (2) US10791932B2 (de)
EP (1) EP2291112B1 (de)
JP (1) JP5594787B2 (de)
CN (1) CN102046072B (de)
BR (1) BRPI0909586A2 (de)
ES (1) ES2655479T3 (de)
RU (1) RU2501515C2 (de)
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Publication number Priority date Publication date Assignee Title
EP2384431B1 (de) * 2008-10-13 2017-11-29 Hemics B.V. Vorrichtung und verfahren zur optischen untersuchung eines trüben mediums mit gelenken
EP2378953B1 (de) * 2008-12-05 2017-08-16 Hemics B.V. Vorrichtung zum optischen nachweis des zustands von gelenken
EP2642910B1 (de) * 2010-11-26 2020-10-07 DEMCON hemics B.V. Vorrichtung und verfahren zur bestimmung einer krankheitsaktivität
US20130331669A1 (en) * 2012-06-11 2013-12-12 Raytheon Company Multi-spectral imaging system and method for remote biometric measurement of human physiological parameters
JP6171768B2 (ja) * 2013-09-13 2017-08-02 カシオ計算機株式会社 脱水状態判定装置
JP6378051B2 (ja) 2014-11-11 2018-08-22 日本光電工業株式会社 測定システム、及び測定装置
JP6477792B2 (ja) * 2017-07-05 2019-03-06 カシオ計算機株式会社 脱水状態判定装置
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RU2501515C2 (ru) 2013-12-20
US20110066034A1 (en) 2011-03-17
RU2010153312A (ru) 2012-07-10
EP2291112A2 (de) 2011-03-09
CN102046072B (zh) 2013-04-24
ES2655479T3 (es) 2018-02-20
US10791932B2 (en) 2020-10-06
BRPI0909586A2 (pt) 2015-09-22
WO2009147560A3 (en) 2010-01-28
US20200305717A1 (en) 2020-10-01
CN102046072A (zh) 2011-05-04
JP2011520581A (ja) 2011-07-21
JP5594787B2 (ja) 2014-09-24
WO2009147560A2 (en) 2009-12-10

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